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| Frequently Asked Questions |
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Patient Information  Frequently Asked Questions |
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| This page presents a list of commonly asked questions pertinent to the GI procedures performed by our faculty. The questions are presented in three sections - Pre-Procedure, Day-of-Procedure and Post-Procedure. If you have additional questions not found on this page, please review the Preparation Instruction pages for either Parnassus or Mount Zion, the Procedures page (at left under Patient Information), one of the Clinical Services pages (at left), or feel free to contact us via phone or email. |
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| Pre-Procedure Questions |
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| How do I prepare for an upper endoscopy (EGD)/ERCP/Upper EUS? |
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| How do I prepare for a colonoscopy exam ? The standard preparation for colonoscopy begins the morning of the day before your test. After having a light breakfast, the rest of the day should consist only of a clear liquid diet. No solid food or milk products. Just tea, Jell-O, clear broth, and water. Most of our patients will be asked to use either the fleets phosphosoda or Golytely/Colyte preparations. You will take these preparations as instructed. You should not make plans for that evening, as you will likely be using the restroom for much of that time. Don't start your preparation too late, or you may spend much of the night going to the restroom. The remainder of the instructions regarding taking your medicine and arranging for a ride are the same as for the upper endoscopy (EGD) test. What if I can't find a responsible adult to accompany me home? If you cannot find anyone, you may have to reschedule your procedure. Contact your physician's office in advance if you think this will be a problem. They may be able to offer you some suggestions. Occasionally, a special transport service may possibly be arranged. Please note: It is not possible to go home via taxi or bus unless an adult accompanies you. You must be able to be accompanied by a friend, family member, or a transport service that specializes in medical transportation. I lost my instructions on how to prepare for my procedure. How do I get another copy or figure out what to do? You can print out the instructions again by going to the Patient Information bar on our home page and moving the cursor over the Prep Instructions bar and selecting the office practice location to which your doctor belongs to. Then select the procedure that you are having and a PDF version of the instructions will appear which you can read or print out. If you are unable to do this, please contact your physician's office. I just realized I should have stopped my aspirin! What should I do? You should contact your physician or their office immediately to determine if you will need to reschedule your procedure. The use of aspirin likely increases your risk of bleeding if any form of cutting is performed. Depending on the reason for your procedure, this may represent an unacceptable risk and possibly will result in rescheduling your procedure. What is the difference between the large volume (golytely-type) of preparation and the fleets phosphosoda preparation? The large volume solutions are safe for use in all individuals and generally are free of inducing any changes in the lining of the GI tract. The fleets phosphosoda preparation has the advantage of requiring drinking only 1 cup of the preparation solution followed by 2 glasses of water on 2 occasions (separated by a few hours). However, because it can draw fluid away from your circulation, it is not recommended for patients with congestive heart failure or kidney problems. Rarely, this prep can lead to small, temporary changes in the appearance of the colon. However, many of our physicians choose this preparation because it is easier for patients to take. Talk to your physician to be sure which preparation they prefer. Does it matter which brand or flavor of the large-volume preparation solution I use? Generally not. There are several brands of the lavage solution - GoLytely, NuLytely, CoLyte, and generic PEG lavage solution. Which one you get often depends on what your pharmacist has in stock, your insurance company, and your preference for flavor. They are all clear in color and come in a variety of flavors and unflavored. They generally work about the same. Do I have to drink all 4 quarts of the laxative preparation solution? If your doctor has prescribed this solution for your preparation, it is very important you drink all of it. The lone exception is if your stools are perfectly clear before you have finished all of the solution, which rarely occurs. Remember that you have several feet of digestive tract and it takes a fairly large volume to completely clean out the colon. To have an optimal and accurate exam, it is important that your preparation for the test is complete. If your colon is not well cleaned out, the procedure may have to be terminated and rescheduled for another day. I can't get/keep the preparation down or I'm not "cleaned out" for my colonoscopy/sigmoidoscopy. Should I reschedule? There are a few techniques available for taking the colonoscopy and sigmoidoscopy preparations. These include taking small amounts of the preparation at short intervals and mixing the prep with ice/clear liquids such as Sprite/7-Up/apple juice. If this does not work and you are not "prepped" i.e. your stools are not relatively clear and entirely liquid, you may need to reschedule your procedure to a later date or later on during the same day while you continue your preparation. It is important to remember that that a thorough exam is not possible without an adequate preparation. What if I have a cold? Can I still have my procedure? Typically, you can still have your procedure done with a cold. However, if you have a high fever or are short of breath, your procedure may be delayed until your cold passes. Please contact your physician if you have concerns about undergoing the procedure in this situation. Is it ok to have a colonoscopy/sigmoidoscopy while menstruating? Your examination should not be compromised if it is performed during a menstrual period. If you have specific concerns, please notify your physician. |
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| Day-of-Procedure Questions | |
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| Is it ok to take my medications on the morning of the procedure? Typically, the answer is yes. However, you should confirm this with your physician if you have any questions. We recommend that you take your blood pressure, cardiac, anti-rejection, anti-seizure and other medications on the morning of your procedure, if this is when you usually take them. It is acceptable to take these pills with a sip of water, even though you are "NPO". However, unless notified by your physician, you should not eat or drink anything else on the day of your procedure until your exam is completed. For diabetics, typically taking 1/2 of your usual morning dose of oral medication or insulin is recommended. For patients on anti-clotting medications (coumadin, aspirin, and anti-platelet drugs) or NSAIDS (most commonly ibuprofen products such as Aleve, Nuprin, and Motrin), these medications are typically stopped 1 week prior to the procedure, if possible. If you are taking anti-clotting medications or NSAIDS, confirm with your physician exactly how to take your medications. Why do I need to come in an hour before my appointment? Typically, patients are asked to arrive 1 hour before their procedure start time. This allows for the appropriate paperwork to be done, time for a change of clothes, and for the placement of an intravenous (IV) line if sedation is planned. How long will I be at the endoscopy unit? This depends, in part, on your procedure. Typically, patients are asked to arrive 1 hour before their procedure start time. This allows for the appropriate paperwork to be done, time for a change of clothes, and for the placement of an intravenous (IV) line if sedation is planned. Endoscopy (EGD), colonoscopy, and ERCP procedures typically are one hour (including sedation time). Sigmoidoscopy is usually shorter (30 min), due to the absence of sedation and the shorter length of colon to be examined. Endoscopic Ultrasound (EUS) procedures take from between 30-90 minutes, depending on the indication and whether a fine-needle aspiration is necessary. Recovery times for most procedures are 30-90 minutes. Thus, you will, on average, spend 3 hours in our unit (less for flexible sigmoidoscopy, longer for EUS). Please be aware that these times are estimates and that your ride should be flexible. Does my ride need to wait in the department for me? No. They just need to be able to be reached to inform them of the appropriate pick-up time. As long as they are continuously available by phone or pager, they do not need to wait in the endoscopy unit. I have a really active gag reflex. Will this interfere with my upper endoscopy (EGD)? Typically not. With the effects of sedation and the relatively small diameter of the scopes, most patients are able to swallow the endoscopes without much difficulty. Occasionally, some patients may also benefit from topical anesthesia ("numbing spray") to the back of the throat. However, many patients find this spray more irritating than soothing. Will my procedure hurt? Will I be asleep? Do I need to have an IV? Endoscopic procedures may occasionally cause mild discomfort, usually because of the gas instilled in the GI tract in order to obtain good visualization of the tissues. At times, advancing the colonoscope through the colon, especially the right side of the colon, may be associated with some discomfort. Patients undergoing an upper endoscopy typically will gag without sedation. As a result, we feel patients will have the best experience with some sedation, which is administered through an IV for the quickest and best results. The medications administered serve to relieve discomfort and provide some amnesia with respect to the procedure. However, patients typically do not receive general anesthesia, as they would during surgery. If you have concerns regarding your ability to be adequately sedated, please mention this to your physician. However, with sedation, most patients have a pain-free procedure and don't recall much, if any, of the procedure. What should I expect during my procedure? After your pre-procedure assessment, you will be taken by a gurney to the procedure room. We will place you on equipment that monitors your heartbeat, oxygenation levels, and blood pressure and give you nasal oxygen. You will then be asked to roll onto your left side on the padded stretcher. We then will administer the sedatives into your intravenous line, and you will likely remember little else until you wake up. You should undergo your procedure in a pleasant semiconscious state in which you feel little pain and remember little of the test itself. |
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| Post Procedure Questions |
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| How will I feel after my test? After your test, you may have a dry mouth or feel drowsy, bloated, or hungry. The dry mouth and drowsiness are from the sedation and will gradually wear off. The bloating results from the air that is inflated into the digestive tract during the procedure. This helps your doctor perform a thorough exam. Even though we try to remove most of the air after the procedure, some of it will have to pass naturally. Since fasting is part of the preparation, many patients feel hungry. Once you are awake, you may have some sips of liquids or some crackers. Once you go home, you may have a meal if you don't experience any nausea. Lastly, some patients will have a sore throat after the upper EUS procedure. How long do I have to wait for the results of my test? Unlike radiology tests, the results of an endoscopic procedure are generally immediate (however, biopsy results still take a few days). After you awaken from your sedation, your doctor may be available to discuss the results of the test with you and/or your family. We typically will also give you a written explanation of what was found and what treatment, if any, is needed. You will also have an opportunity to ask questions. This is another reason why it is best to have a companion come with you to your test. The medications tend to make patients groggy, and you may forget what your doctor tells you after the test. It usually helps to have a second person also hear the results of the test and the plan. How long will I be in the recovery room after my test? The average time in our recovery room is about 60 minutes. If you have a private recovery room, your family may stay with you. This allows them to hear what the doctor has to say about the results of your test. Can I wait outside or in the cafeteria for my ride? If you have undergone a procedure with sedation, you must recover in the endoscopy unit until your ride arrives. Again, because of the lingering effects of the sedation, you will require direct observation and monitoring by our nursing staff until someone can safely escort you home. How soon after the procedure can I eat/drink? You may begin drinking liquids once you are awake after the procedure, unless otherwise informed by your physician. Typically, it is better to start with liquids, as you may have some nausea from the medications used to sedate you. If you tolerate the liquids, you may advance your diet to solid foods. Please remember that the medicines used for sedation should not be mixed with alcohol. We suggest you do not drink any alcoholic beverages (beer, wine, whiskey or other spirits) until at least the day after your procedure. Why can't I drive after a procedure with sedation? Despite how you may feel, your ability to concentrate and focus are not back to normal 1-2 hours after sedation, which is when patients typically leave the endoscopy unit. As a result, it is unsafe to drive at this time. Patients are not safe to drive until the day after the procedure. Your reflexes will be slower than usual and you will not be legally able to drive until the next day. Can I go back to work after my procedure? Typically, we recommend you take the rest of the day off after your procedure. Most patients have some lingering effects of sedation and likely will not perform up to their usual standards. If missing a day of work is a concern, speak with your physician regarding the possibility of scheduling an early afternoon procedure, which will allow you to work at least part of the morning before arriving for your procedure. How long do I have to wait before I fly or travel after my test? The risk of complications is very low for these procedures. In general, if you feel well, you may fly or travel the day after your procedure. However, if the doctor removes a large polyp or if your procedure was unusual in any way, he may request that you stay in the area for at least a week after the exam. This rarely occurs. Certainly, you should not travel to any part of the world where medical attention is not readily available right after any medical procedure. Should a complication occur, you may need prompt medical attention. Why am I not having my normal bowel movement the day after my procedure? This is a frequent complaint in patients undergoing colonoscopy. The reasons are many and include the effects of sedation (which slow down your bowels) and the fact that your bowels were empty at the time of the procedure and that you may not have eaten much on the day of your procedure. Most patients will resume normal bowel movements within 1-2 days of their procedure. |
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